title: Updated consensus statement on the use of rituximab in patients with rheumatoid arthritis.
abstract: BACKGROUND
  Since initial approval for the treatment of rheumatoid arthritis (RA), rituximab has been evaluated in clinical trials involving various populations with RA. Information has also been gathered from registries. This report therefore updates the 2007 consensus document on the use of rituximab in the treatment of RA.
  
  
  METHODS
  Preparation of this new document involved many international experts experienced in the treatment of RA. Following a meeting to agree upon the core agenda, a systematic literature review was undertaken to identify all relevant data. Data were then interrogated by a drafting committee, with subsequent review and discussion by a wider expert committee leading to the formulation of an updated consensus statement. These committees also included patients with RA.
  
  
  RESULTS
  The new statement covers wide-ranging issues including the use of rituximab in earlier RA and impact on structural progression, and aspects particularly pertinent to rituximab such as co-medication, optimal dosage regimens, repeat treatment cycles and how to manage non-response. Biological therapy following rituximab usage is also addressed, and safety concerns including appropriate screening for hepatitis, immunoglobulin levels and infection risk. This consensus statement will support clinicians and inform patients when using B-cell depletion in the management of RA, providing up-to-date information and highlighting areas for further research.
  
  
  CONCLUSIONS
  New therapeutic strategies and treatment options for RA, a chronic destructive and disabling disease, have expanded over recent years. These have been summarised in general strategic suggestions and specific management recommendations, emphasising the importance of expedient disease-modifying antirheumatic drug implementation and tight disease control. This consensus statement is in line with these fundamental principles of management.
authors.affiliation: Section of Musculoskeletal Diseases, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK.
authors.forename: Maya H
authors.initials: MH
authors.lastname: Buch
authors.forename: Josef S
authors.initials: JS
authors.lastname: Smolen
authors.forename: Neil
authors.initials: N
authors.lastname: Betteridge
authors.forename: Ferdinand C
authors.initials: FC
authors.lastname: Breedveld
authors.forename: Gerd
authors.initials: G
authors.lastname: Burmester
authors.forename: Thomas
authors.initials: T
authors.lastname: Dörner
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Ferraccioli
authors.forename: Jacques-Eric
authors.initials: JE
authors.lastname: Gottenberg
authors.forename: John
authors.initials: J
authors.lastname: Isaacs
authors.forename: Tore K
authors.initials: TK
authors.lastname: Kvien
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
authors.forename: Emilio
authors.initials: E
authors.lastname: Martin-Mola
authors.forename: Karel
authors.initials: K
authors.lastname: Pavelka
authors.forename: Paul P
authors.initials: PP
authors.lastname: Tak
authors.forename: Desiree
authors.initials: D
authors.lastname: van der Heijde
authors.forename: Ronald F
authors.initials: RF
authors.lastname: van Vollenhoven
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine / Q000379:methods; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D005938:Glucocorticoids; D000069283:Rituximab